Less than one fifth of PhD students in the United States will be able to pursue tenure track academic faculty careers once they graduate from their program. Reduced federal funding for research and dwindling support from the institutions for their tenure-track faculty are some of the major reasons for why there is such an imbalance between the large numbers of PhD graduates and the limited availability of academic positions. Upon completing the program, PhD graduates have to consider non-academic job opportunities such as in the industry, government agencies and non-profit foundations but not every doctoral program is equally well-suited to prepare their graduates for such alternate careers. It is therefore essential for prospective students to carefully assess the doctoral program they want to enroll in and the primary mentor they would work with. The best approach is to proactively contact prospective mentors, meet with them and learn about the research opportunities in their group but also discuss how completing the doctoral program would prepare them for their future careers.

The vast majority of professors will gladly meet a prospective graduate student and discuss research opportunities as well as long-term career options, especially if the student requesting the meeting clarifies the goal of the meeting. However, there are cases when students wait in vain for a response. Is it because their email never reached the professor because it got lost in the internet ether or a spam folder? Was the professor simply too busy to respond? A research study headed by Katherine Milkman from the University of Pennsylvania suggests that the lack of response from the professor may in part be influenced by the perceived race or gender of the student.

Milkman and her colleagues conducted a field experiment in which 6,548 professors at the leading US academic institutions (covering 89 disciplines) were contacted via email to meet with a prospective graduate student. Here is the text of the email that was sent to each professor.

Subject Line: Prospective Doctoral Student (On Campus Next

Monday)

Dear Professor [surname of professor inserted here],

I am writing you because I am a prospective doctoral student with considerable interest in your research. My plan is to apply to doctoral programs this coming Fall, and I am eager to learn as much as I can about research opportunities in the meantime.

I will be on campus next Monday, and although I know it is short notice, I was wondering if you might have 10 minutes when you would be willing to meet with me to briefly talk about your work and any possible opportunities for me to get involved in your research. Any time that would be convenient for you would be fine with me, as meeting with you is my first priority during this campus visit.

Thank you in advance for your consideration.

Sincerely,

[Student’s full name inserted here]

As a professor who frequently receives emails from people who want to work in my laboratory, I feel that the email used in the research study was extremely well-crafted. The student only wants a brief meeting to explore potential opportunities without trying to extract any specific commitment from the professor. The email clearly states the long-term goal – applying to doctoral programs. The tone is also very polite and the student expresses willingness of the prospective student to a to the professor’s schedule. Each email was also personally addressed with the name of the contacted faculty member.

Milkman’s research team then assessed whether the willingness of the professors to respond depended on the gender or ethnicity of the prospective student. Since this was an experiment, the emails and student names were all fictional but the researchers generated names which most readers would clearly associate with a specific gender and ethnicity.

Here is a list of the names they used:

White male names: Brad Anderson, Steven Smith

White female names: Meredith Roberts, Claire Smith

Black male names: Lamar Washington, Terell Jones

Black female names: Keisha Thomas, Latoya Brown

Hispanic male names: Carlos Lopez, Juan Gonzalez

Hispanic female names: Gabriella Rodriguez, Juanita Martinez

Indian male names: Raj Singh, Deepak Patel

Indian female names: Sonali Desai, Indira Shah

Chinese Male names; Chang Huang, Dong Lin

Chinese female names: Mei Chen, Ling Wong

The researchers assessed whether the professors responded (either by agreeing to meet or providing a reason for why they could not meet) at all or whether they simply ignored the email and whether the rate of response depended on the ethnicity/gender of the student.

The overall response rate of the professors ranged from about 60% to 80%, depending on the research discipline as well as the perceived ethnicity and gender of the prospective student. When the emails were signed with names suggesting a white male background of the student, professors were far less likely to ignore the email when compared to those signed with female names or names indicating an ethnic minority background. Professors in the business sciences showed the strongest discrimination in their response rates. They ignored only 18% of emails when it appeared that they had been written by a white male and ignored 38% of the emails if they were signed with names indicating a female gender or ethnic minority background. Professors in the education disciplines ignored 21% of emails with white male names versus 35% with female or minority names. The discrimination gaps in the health sciences (33% vs 43%) and life sciences (32% vs 39%) were smaller but still significant, whereas there was no statistical difference in the humanities professor response rates. Doctoral programs in the fine arts were an interesting exception where emails from apparent white male students were more likely to be ignored (26%) than those of female or minority candidates (only 10%).

The discrimination primarily occurred at the initial response stage. When professors did respond, there was no difference in terms of whether they were able to make time for the student. The researchers also noted that responsiveness discrimination in any discipline was not restricted to one gender or ethnicity. In business doctoral programs, for example, professors were most likely to ignore emails with black female names and Indian male names. Significant discrimination against white female names (when compared to white males names) predicted an increase in discrimination against other ethnic minorities. Surprisingly, the researchers found that having higher representation of female and minority faculty at an institution did not necessarily improve the responsiveness towards requests from potential female or minority students.

This carefully designed study with a large sample size of over 6,500 professors reveals the prevalence of bias against women and ethnic minorities at the top US institutions. This bias may be so entrenched and subconscious that it cannot be remedied by simply increasing the percentage of female or ethnic minority professors in academia. Instead, it is important that professors understand that they may be victims of these biases even if they do not know it. Something as simple as deleting an email from a prospective student because we think that we are too busy to respond may be indicative of an insidious gender or racial bias that we need to understand and confront. Increased awareness and introspection as well targeted measures by institutions are the important first steps to ensure that students receive the guidance and mentorship they need, independent of their gender or ethnic background.

Hearing about the HannoverGEN project made me feel envious and excited. Envious, because I wish my high school had offered the kind of hands-on molecular biology training provided to high school students in Hannover, the capital of the German state of Niedersachsen. Excited, because it reminded me of the joy I felt when I first isolated DNA and ran gels after restriction enzyme digests during my first year of university in Munich. I knew that many of the students at the HannoverGEN high schools would be similarly thrilled by their laboratory experience and perhaps even pursue careers as biologists or biochemists.

What did HannoverGEN entail? It was an optional pilot program initiated and funded by the state government of Niedersachsen at four high schools in the Hannover area. Students enrolled in the HannoverGEN classes would learn to use molecular biology tools typically reserved for college-level or graduate school courses in order to study plant genetics. Some of the basic experiments involved isolating DNA from cabbage or how learning how bacteria transfer genes to plants, more advanced experiments enabled the students to analyze whether or not the genome of a provided maize sample had been genetically modified. Each experimental unit was accompanied by relevant theoretical instruction on the molecular mechanisms of gene expression and biotechnology as well as ethical discussions regarding the benefits and risks of generating genetically modified organisms (“GMOs”). The details of the HannoverGEN program are only accessible through the the Wayback Machine Internet archive because the award-winning educational program and the associated website were shut down in 2013 at the behest of German anti-GMO activist groups, environmental activists, Greenpeace, the Niedersachsen Green Party and the German organic food industry.

Why did these activists and organic food industry lobbyists oppose a government-funded educational program which improved the molecular biology knowledge and expertise of high school students? A press release entitled “Keine Akzeptanzbeschaffung für Agro-Gentechnik an Schulen!” (“No Acceptance for Agricultural Gene Technology at Schools“) in 2012 by an alliance representing “organic” or “natural food” farmers accompanied by the publication of a critical “study” with the same title (PDF), which was funded by this alliance as well as its anti-GMO partners, gives us some clues. They feared that the high school students might become too accepting of biotechnology in agriculture and that the curriculum did not sufficiently highlight all the potential dangers of GMOs. By allowing the ethical discussions to not only discuss the risks but also mention the benefits of genetically modifying crops, students might walk away with the idea that GMOs could be beneficial for humankind. The group believed that taxpayer money should not be used to foster special interests such as those of the agricultural industry which may want to use GMOs.

A response by the University of Hannover (PDF), which had helped develop the curriculum and coordinated the classes for the high school students, carefully analyzed the complaints of the anti-GMO activists. The author of the anti-HannoverGEN “study” had not visited the HannoverGEN laboratories, nor had he had interviewed the biology teachers or students enrolled in the classes. In fact, his critique was based on weblinks that were not even used in the curriculum by the HannoverGEN teachers or students. His analysis ignored the balanced presentation of biotechnology that formed the basis of the HannoverGEN curriculum and that discussing potential risks of genetic modification was a core topic in all the classes.

Unfortunately, this shoddily prepared “study” had a significant impact, in part because it was widely promoted by partner organizations. Its release in the autumn of 2012 came at an opportune time for political activists because Niedersachsen was about to have an election. Campaigning against GMOs seemed like a perfect cause for the Green Party and a high school program which taught the use of biotechnology to high school students became a convenient lightning rod. When the Social Democrats and the Green Party formed a coalition after winning the election in early 2013, nixing the HannoverGEN high school program was formally included in the so-called coalition contract. This is a document in which coalition partners outline the key goals for the upcoming four year period. When one considers how many major issues and problems the government of a large German state has to face, such as healthcare, education, unemployment or immigration, it is mind-boggling that de-funding a program involving only four high schools received so much attention that it needed to be anchored in the coalition contract. In fact, it is a testimony to the influence and zeal of the anti-GMO lobby.

Once the cancellation of HannoverGEN was announced, the Hannover branch of Greenpeace also took credit for campaigning against this high school program and celebrated its victory. The Greenpeace anti-GMO activist David Petersen said that the program was too cost intensive because equipping high school laboratories with state-of-the-art molecular biology equipment had already cost more than 1 million Euros. The previous center-right government which had initiated the HannoverGEN project was planning on expanding the program to even more high schools because of the program’s success and national recognition for innovative teaching. According to Petersen, this would have wasted even more taxpayer money without adequately conveying the dangers of using GMOs in agriculture.

The scientific community was shaken up by the decision of the new Social Democrat-Green Party coalition government in Niedersachsen. This was an attack on the academic freedom of schools under the guise of accusing them of promoting special interests while ignoring that the anti-GMO activists were representing their own special interests. The “study” attacking HannoverGEN was funded by the lucrative “organic” or “natural food” food industry! Scientists and science writers such as Martin Ballaschk or Lars Fischer wrote excellent critical articles stating that squashing high-quality, hand-on science programs could not lead to better decision-making. How could ignorant students have a better grasp of GMO risks and benefits than those who receive relevant formal science education and thus make truly informed decisions? Sadly, this outcry by scientists and science writers did not make much of a difference. It did not seem that the media felt this was much of a cause to fight for. I wonder if the media response would have been just as lackluster if the government had de-funded a hands-on science lab to study the effects of climate change.

In 2014, the government of Niedersachsen then announced that they would resurrect an advanced biology laboratory program for high schools with the generic and vague title “Life Science Lab”. By removing the word “Gen” from its title which seems to trigger visceral antipathy among anti-GMO activists, de-emphasizing genome science and by also removing any discussion of GMOs from the curriculum, this new program would leave students in the dark about GMOs. Ignorance is bliss from an anti-GMO activist perspective because the void of scientific ignorance can be filled with fear.

From the very first day that I could vote in Germany during the federal election of 1990, I always viewed the Green Party as a party that represented my generation. A party of progressive ideas, concerned about our environment and social causes. However, the HannoverGEN incident is just one example of how the Green Party is caving in to ideologies, thus losing its open-mindedness and progressive nature. In the United States, the anti-science movement, which attacks teaching climate change science or evolutionary biology at schools, tends to be rooted in the right wing political spectrum. Right wingers or libertarians are the ones who always complain about taxpayer dollars being wasted and used to promote agendas in schools and universities. But we should not forget that there is also a different anti-science movement rooted in the leftist and pro-environmental political spectrum – not just in Germany. As a scientist, I feel that it is becoming increasingly difficult to support the Green Party because of its anti-science stance.

I worry about all anti-science movements, especially those which attack science education. There is nothing wrong with questioning special interests and ensuring that school and university science curricula are truly balanced. But the balance needs to be rooted in scientific principles, not political ideologies. Science education has a natural bias – it is biased towards knowledge that is backed up by scientific evidence. We can hypothetically discuss dangers of GMOs but the science behind the dangers of GMO crops is very questionable. Just like environmental activists and leftists agree with us scientists that we do not need to give climate change deniers and creationists “balanced” treatment in our science curricula, they should also accept that much of the “anti-GMO science” is currently more based on ideology than on actual scientific data. Our job is to provide excellent science education so that our students can critically analyze and understand scientific research, independent of whether or not it supports our personal ideologies.

“It’s empathy that makes us help other people. It’s empathy that makes us moral.” The economist Paul Zak casually makes this comment in his widely watched TED talk about the hormone oxytocin, which he dubs the “moral molecule”. Zak quotes a number of behavioral studies to support his claim that oxytocin increases empathy and trust, which in turn increases moral behavior. If all humans regularly inhaled a few puffs of oxytocin through a nasal spray, we could become more compassionate and caring. It sounds too good to be true. And recent research now suggests that this overly simplistic view of oxytocin, empathy and morality is indeed too good to be true.

Many scientific studies support the idea that oxytocin is a major biological mechanism underlying the emotions of empathy and the formation of bonds between humans. However, inferring that these oxytocin effects in turn make us more moral is a much more controversial statement. In 2011, the researcher Carsten De Dreu and his colleagues at the University of Amsterdam in the Netherlands published the study Oxytocin promotes human ethnocentrism which studied indigenous Dutch male study subjects who in a blinded fashion self-administered either nasal oxytocin or a placebo spray. The subjects then answered questions and performed word association tasks after seeing photographic images of Dutch males (the “in-group”) or images of Arabs and Germans, the “out-group” because prior surveys had shown that the Dutch public has negative views of both Arabs/Muslims and Germans. To ensure that the subjects understood the distinct ethnic backgrounds of the target people shown in the images, they were referred to typical Dutch male names, German names (such as Markus and Helmut) or Arab names (such as Ahmed and Youssef).

Oxytocin increased favorable views and word associations but only towards in-group images of fellow Dutch males. The oxytocin treatment even had the unexpected effect of worsening the views regarding Arabs and Germans but this latter effect was not quite statistically significant. Far from being a “moral molecule”, oxytocin may actually increase ethnic bias in society because it selectively enhances certain emotional bonds. In a subsequent study, De Dreu then addressed another aspect of the purported link between oxytocin and morality by testing the honesty of subjects. The study Oxytocin promotes group-serving dishonesty showed that oxytocin increased cheating in study subjects if they were under the impression that dishonesty would benefit their group. De Dreu concluded that oxytocin does make us less selfish and care more about the interest of the group we belong to.

These recent oxytocin studies not only question the “moral molecule” status of oxytocin but raise the even broader question of whether more empathy necessarily leads to increased moral behavior, independent of whether or not it is related to oxytocin. The researchers Jean Decety and Jason Cowell at the University of Chicago recently analyzed the scientific literature on the link between empathy and morality in their commentary Friends or Foes: Is Empathy Necessary for Moral Behavior?, and find that the relationship is far more complicated than one would surmise. Judges, police officers and doctors who exhibit great empathy by sharing in the emotional upheaval experienced by the oppressed, persecuted and severely ill always end up making the right moral choices – in Hollywood movies. But empathy in the real world is a multi-faceted phenomenon and we use this term loosely, as Decety and Cowell point out, without clarifying which aspect of empathy we are referring to.

Decety and Cowell distinguish at least three distinct aspects of empathy:

1. Emotional sharing, which refers to how one’s emotions respond to the emotions of those around us. Empathy enables us to “feel” the pain of others and this phenomenon of emotional sharing is also commonly observed in non-human animals such as birds or mice.

2. Empathic concern, which describes how we care for the welfare of others. Whereas emotional sharing refers to how we experience the emotions of others, empathic concern motivates us to take actions that will improve their welfare. As with emotional sharing, empathic concern is not only present in humans but also conserved among many non-human species and likely constitutes a major evolutionary advantage.

3. Perspective taking, which – according to Decety and Cowell – is the ability to put oneself into the mind of another and thus imagine what they might be thinking or feeling. This is a more cognitive dimension of empathy and essential for our ability to interact with fellow human beings. Even if we cannot experience the pain of others, we may still be able to understand or envision how they might be feeling. One of the key features of psychopaths is their inability to experience the emotions of others. However, this does not necessarily mean that psychopaths are unable to cognitively imagine what others are thinking. Instead of labeling psychopaths as having no empathy, it is probably more appropriate to specifically characterize them as having a reduced capacity to share in the emotions while maintaining an intact capacity for perspective-taking.

In addition to the complexity of what we call “empathy”, we need to also understand that empathy is usually directed towards specific individuals and groups. De Dreu’s studies demonstrated that oxytocin can make us more pro-social as long as it benefits those who we feel belong to our group but not necessarily those outside of our group. The study Do you feel my pain? Racial group membership modulates empathic neural responses by Xu and colleagues at Peking University used fMRI brain imaging in Chinese and Caucasian study subjects and measured their neural responses to watching painful images. The study subjects were shown images of either a Chinese or a Caucasian face. In the control condition, the depicted image showed a face being poked with a cotton swab. In the pain condition, study subjects were shown a face of a person being poked with a needle attached to syringe. When the researchers measured the neural responses with the fMRI, they found significant activation in the anterior cingulate cortex (ACC) which is part of the neural pain circuit, both for pain we experience ourselves but also for empathic pain we experience when we see others in pain. The key finding in Xu’s study was that ACC activation in response to seeing the painful image was much more profound when the study subject and the person shown in the painful image belonged to the same race.

As we realize that the neural circuits and hormones which form the biological basis of our empathy responses are so easily swayed by group membership then it becomes apparent why increased empathy does not necessarily result in behavior consistent with moral principles. In his essay “Against Empathy“, the psychologist Paul Bloom also opposes the view that empathy should form the basis of morality and that we should unquestioningly elevate empathy to virtue for all:

“But we know that a high level of empathy does not make one a good person and that a low level does not make one a bad person. Being a good person likely is more related to distanced feelings of compassion and kindness, along with intelligence, self-control, and a sense of justice. Being a bad person has more to do with a lack of regard for others and an inability to control one’s appetites.”

I do not think that we can dismiss empathy as a factor in our moral decision-making. Bloom makes a good case for distanced compassion and kindness that does not arise from the more visceral emotion of empathy. But when we see fellow humans and animals in pain, then our initial biological responses are guided by empathy and anger, not the more abstract concept of distanced compassion. What we need is a better scientific and philosophical understanding of what empathy is. Empathic perspective-taking may be a far more robust and reliable guide for moral decision-making than empathic emotions. Current scientific studies on empathy often measure it as an aggregate measure without teasing out the various components of empathy. They also tend to underestimate that the relative contributions of the empathy components (emotion, concern, perspective-taking) can vary widely among cultures and age groups. We need to replace overly simplistic notions such as oxytocin = moral molecule or empathy = good with a more refined view of the complex morality-empathy relationship guided by rigorous science and philosophy.

Murder your darlings. The British writer Sir Arthur Quiller Crouch shared this piece of writerly wisdom when he gave his inaugural lecture series at Cambridge, asking writers to consider deleting words, phrases or even paragraphs that are especially dear to them. The minute writers fall in love with what they write, they are bound to lose their objectivity and may not be able to judge how their choice of words will be perceived by the reader. But writers aren’t the only ones who can fall prey to the Pygmalion syndrome. Scientists often find themselves in a similar situation when they develop “pet” or “darling” hypotheses.

How do scientists decide when it is time to murder their darling hypotheses? The simple answer is that scientists ought to give up scientific hypotheses once the experimental data is unable to support them, no matter how “darling” they are. However, the problem with scientific hypotheses is that they aren’t just generated based on subjective whims. A scientific hypothesis is usually put forward after analyzing substantial amounts of experimental data. The better a hypothesis is at explaining the existing data, the more “darling” it becomes. Therefore, scientists are reluctant to discard a hypothesis because of just one piece of experimental data that contradicts it.

In addition to experimental data, a number of additional factors can also play a major role in determining whether scientists will either discard or uphold their darling scientific hypotheses. Some scientific careers are built on specific scientific hypotheses which set apart certain scientists from competing rival groups. Research grants, which are essential to the survival of a scientific laboratory by providing salary funds for the senior researchers as well as the junior trainees and research staff, are written in a hypothesis-focused manner, outlining experiments that will lead to the acceptance or rejection of selected scientific hypotheses. Well written research grants always consider the possibility that the core hypothesis may be rejected based on the future experimental data. But if the hypothesis has to be rejected then the scientist has to explain the discrepancies between the preferred hypothesis that is now falling in disrepute and all the preliminary data that had led her to formulate the initial hypothesis. Such discrepancies could endanger the renewal of the grant funding and the future of the laboratory. Last but not least, it is very difficult to publish a scholarly paper describing a rejected scientific hypothesis without providing an in-depth mechanistic explanation for why the hypothesis was wrong and proposing alternate hypotheses.

For example, it is quite reasonable for a cell biologist to formulate the hypothesis that protein A improves the survival of neurons by activating pathway X based on prior scientific studies which have shown that protein A is an activator of pathway X in neurons and other studies which prove that pathway X improves cell survival in skin cells. If the data supports the hypothesis, publishing this result is fairly straightforward because it conforms to the general expectations. However, if the data does not support this hypothesis then the scientist has to explain why. Is it because protein A did not activate pathway X in her experiments? Is it because in pathway X functions differently in neurons than in skin cells? Is it because neurons and skin cells have a different threshold for survival? Experimental results that do not conform to the predictions have the potential to uncover exciting new scientific mechanisms but chasing down these alternate explanations requires a lot of time and resources which are becoming increasingly scarce. Therefore, it shouldn’t come as a surprise that some scientists may consciously or subconsciously ignore selected pieces of experimental data which contradict their darling hypotheses.

Let us move from these hypothetical situations to the real world of laboratories. There is surprisingly little data on how and when scientists reject hypotheses, but John Fugelsang and Kevin Dunbar at Dartmouth conducted a rather unique study “Theory and data interactions of the scientific mind: Evidence from the molecular and the cognitive laboratory” in 2004 in which they researched researchers. They sat in at scientific laboratory meetings of three renowned molecular biology laboratories at carefully recorded how scientists presented their laboratory data and how they would handle results which contradicted their predictions based on their hypotheses and models.

In their final analysis, Fugelsang and Dunbar included 417 scientific results that were presented at the meetings of which roughly half (223 out of 417) were not consistent with the predictions. Only 12% of these inconsistencies lead to change of the scientific model (and thus a revision of hypotheses). In the vast majority of the cases, the laboratories decided to follow up the studies by repeating and modifying the experimental protocols, thinking that the fault did not lie with the hypotheses but instead with the manner how the experiment was conducted. In the follow up experiments, 84 of the inconsistent findings could be replicated and this in turn resulted in a gradual modification of the underlying models and hypotheses in the majority of the cases. However, even when the inconsistent results were replicated, only 61% of the models were revised which means that 39% of the cases did not lead to any significant changes.

The study did not provide much information on the long-term fate of the hypotheses and models and we obviously cannot generalize the results of three molecular biology laboratory meetings at one university to the whole scientific enterprise. Also, Fugelsang and Dunbar’s study did not have a large enough sample size to clearly identify the reasons why some scientists were willing to revise their models and others weren’t. Was it because of varying complexity of experiments and models? Was it because of the approach of the individuals who conducted the experiments or the laboratory heads? I wish there were more studies like this because it would help us understand the scientific process better and maybe improve the quality of scientific research if we learned how different scientists handle inconsistent results.

In my own experience, I have also struggled with results which defied my scientific hypotheses. In 2002, we found that stem cells in human fat tissue could help grow new blood vessels. Yes, you could obtain fat from a liposuction performed by a plastic surgeon and inject these fat-derived stem cells into animal models of low blood flow in the legs. Within a week or two, the injected cells helped restore the blood flow to near normal levels! The simplest hypothesis was that the stem cells converted into endothelial cells, the cell type which forms the lining of blood vessels. However, after several months of experiments, I found no consistent evidence of fat-derived stem cells transforming into endothelial cells. We ended up publishing a paper which proposed an alternative explanation that the stem cells were releasing growth factors that helped grow blood vessels. But this explanation was not as satisfying as I had hoped. It did not account for the fact that the stem cells had aligned themselves alongside blood vessel structures and behaved like blood vessel cells.

Even though I “murdered” my darling hypothesis of fat –derived stem cells converting into blood vessel endothelial cells at the time, I did not “bury” the hypothesis. It kept ruminating in the back of my mind until roughly one decade later when we were again studying how stem cells were improving blood vessel growth. The difference was that this time, I had access to a live-imaging confocal laser microscope which allowed us to take images of cells labeled with red and green fluorescent dyes over long periods of time. Below, you can see a video of human bone marrow mesenchymal stem cells (labeled green) and human endothelial cells (labeled red) observed with the microscope overnight. The short movie compresses images obtained throughout the night and shows that the stem cells indeed do not convert into endothelial cells. Instead, they form a scaffold and guide the endothelial cells (red) by allowing them to move alongside the green scaffold and thus construct their network. This work was published in 2013 in the Journal of Molecular and Cellular Cardiology, roughly a decade after I had been forced to give up on the initial hypothesis. Back in 2002, I had assumed that the stem cells were turning into blood vessel endothelial cells because they aligned themselves in blood vessel like structures. I had never considered the possibility that they were scaffold for the endothelial cells.

This and other similar experiences have lead me to reformulate the “murder your darlings” commandment to “murder your darling hypotheses but do not bury them”. Instead of repeatedly trying to defend scientific hypotheses that cannot be supported by emerging experimental data, it is better to give up on them. But this does not mean that we should forget and bury those initial hypotheses. With newer technologies, resources or collaborations, we may find ways to explain inconsistent results years later that were not previously available to us. This is why I regularly peruse my cemetery of dead hypotheses on my hard drive to see if there are ways of perhaps resurrecting them, not in their original form but in a modification that I am now able to test.

About five million people in the US suffer from heart failure, and approximately half of them die within five years of being diagnosed. Only about 2,500 people a year receive a heart transplant – the treatment of last resort. A new heart can be life-saving, but it is also life-changing. Even under the best conditions, the surgery is complex, and recovery carries a heavy physical and emotional burden.

And not all heart transplant recipients fare equally well after the surgery. Researchers have found that black heart transplant patients are more likely to die after surgery than white or Hispanic patients.

While many different factors contribute to the disparity, the research indicates that where patients received their heart transplants played a big role. Black patients were more likely to have their transplants performed at the worst-performing centers.

This is merely one of many examples of health disparities faced by black Americans. But as a cardiologist, I find this finding especially troubling because many of the heart failure patients I treat are black.

So how do patients decide where to have their heart transplants performed? And wouldn’t a person who needs a heart transplant choose to go to a top center?

Quality is obviously a major factor. But there is another big consideration in deciding where to get a transplant: accessibility.

Not all transplant centers have the same results

Researchers at Ohio State University reviewed the records of heart transplants performed at 102 transplant centers in the US from 2000 to 2010. The researchers focused on the rate of death during the first year after the transplant in over 18,000 heart transplant recipients.

They found that black patients had a higher rate of dying within one year of receiving a new heart (15.3%) than either Hispanics (12.5%) or whites (12.8%).

To find out why this was happening, the researchers used a mathematical model to predict the risk of dying within a year after the transplant for every patient based on the severity of their disease and complicating risk factors such as advanced age or reduced kidney function. They then compared the calculated risk with the actually observed death rates. The difference between the prediction and reality allowed them to determine the quality of a transplant center.

It turned out that a greater proportion of blacks received their heart transplant at centers with higher-than-expected mortality as compared with whites and Hispanics (56.4% versus 47.1% versus 48.1%, respectively).

The contrast was even starker between the top- and worst-performing centers. Blacks had the lowest rate of being transplanted at centers with excellent performance (blacks: 18.5%; whites: 25.3%; Hispanics 28.3%). They also had the highest likelihood of undergoing their transplant surgery at the worst-performing centers.

It turns out that where a person has their transplant is critical. Only 8.7% of black patients died during the first year after the transplant if they were fortunate enough to undergo surgery at a top center. But this number was more than twice as high (18.3%) for blacks at the worst-performing centers.

The study didn’t provide any definitive explanations as to why the majority of blacks underwent heart transplantation at centers with lower than expected outcomes.

Choosing a transplant center isn’t much of a choice

Patients do not “choose” a transplant center by simply looking it up in a catalog or on a website. While performance statistics for each organ transplant center in the United States are publicly available in the Scientific Registry of Transplant Recipients, those statistics are only part of the decision for where a patient will get their transplant. The “choice” is often made for the patients by the doctors who refer them to a transplant center and by the accessibility of the center.

I’m a cardiologist, and in the Chicago area, where I practice, there are five active heart transplant centers. We can show the numbers for the centers to our patients when discussing the possibility of a heart transplant and also provide some additional advice based on our prior experiences with the respective transplant teams. Because our patients are nearly all based in the Chicagoland area, most of these programs are reasonable options for them. However, patients and doctors in cities or regions that don’t have as many transplant centers, or who live in more remote areas may not have the luxury of choice.

Accessibility matters because care doesn’t end with the surgery

Unless you’ve had a heart transplant, or know someone who has, it’s hard to understand just how life-changing the surgery is. I’ve noticed that many people are unprepared for the emotional and physical toll from the surgery and recovery. And it’s this toll that can makes accessibility such an important factor when choosing a transplant center.

After surgery, patients spend a couple of weeks recovering in the hospital. Even when they can go home, their health is closely monitored with frequent lab tests and check ups.

After transplant, patients will start taking medications to suppress their immune systems and keep their body from rejecting the new heart. And they have to stay on these medications for their rest of their lives. This means a lifetime of close monitoring to make sure that their heart is functioning well and that there aren’t any complications from the immune suppression.

For instance, during the first couple of months after surgery, patients have heart biopsies, where a small piece of the heart is removed to check for signs of rejection, every one to two weeks. As recovery progresses, biopsies may become monthly. The heart sample is so small that it does not damage the heart, but the biopsy is still an invasive procedure requiring hospitalization. And waiting for results can be stressful.

All of this means heart recipients spend a lot of time during the first year after their transplant seeing doctors and waiting for test results. Being close to a transplant center is important – it’s just easier to get to appointments. But accessibility isn’t just about the patient. It’s also about their support network. Imagine going through all of that alone.

On a practical level, family members and friends provide rides to the hospital, keep track of medications and doctor’s appointments and help with household chores during the recovery period. But what is most important is the emotional support that they provide.

So why do black transplant patients tend to wind up in transplant centers that don’t perform as well? Right now, we don’t know. Is it because they were referred to these centers by their cardiologists despite other feasible alternatives? What role does the health insurance of patients play in determining where they receive the heart transplant? Why are centers with a high percentage of black transplant recipients performing so poorly? And most importantly, what measures need to be taken to improve the quality of care?

These are important questions that physicians, public health officials and politicians need to ask themselves in order to address these disparities.

This is a guest blog post by Ulli Hain (Twitter: @ulli_hain, Email: hain.ulli[at]gmail.com). Ulli is a postdoctoral researcher in the field of autophagy and also a science writer/blogger. Her blog Bench and Beyond reports on interesting scientific studies and explores life as a scientist including issues of gender and science.

We have all heard the stereotypes: women can’t drive, they don’t understand computers, and how many blondes does it take to screw in a light bulb? But those are all in good fun, right? But what if gender stereotypes actually bring about the observed differences between men and women that supposedly underline these stereotypes? A recent study by the psychologist Marina Pavlova at the University of Tübingen tested this idea.

Boy and Girl at School – Stereotypes about favorites subjects. Via Shutterstock.

While previous studies have supported the idea that negative stereotypes hinder women’s athletic and cognitive performance on a range of tests, those studies all looked at tasks with preexisting stereotypes. For example women score worse on math tests when reminded of old “adages” about women and math.

Pavlova and her colleagues instead wanted to see how stereotype impacts an area where no gender difference exists. Could a fabricated stereotype change the way women and men perform on a test?

They chose the event arrangement (EA) test, used on certain modern IQ tests to measure nonverbal reasoning skills. Participants arrange cards depicting scenes, such as a man fishing, cooking over a campfire, and preparing for a trip, in a logical order to create a story. Scores are based on the number of correct sequences and amount of time required.

117 college students were split into three groups and given different instructions for the test. The first group was given standard instructions on the task. A second group was additionally told: “females usually perform worse on this task” while the third group was told: “males usually perform worse on this task.”

Men and women performed equally well when no stereotyped messages were given. When the group was told that women usually perform worse, women’s scores on the test decreased. In contrast, men’s scores actually increased, perhaps reflecting that their confidence was boosted by the perceived weakness of women. helped boost that they thrived on their perceived advantage.

The most surprising findings came from the group that was told that men usually do worse on the test. Men’s performance was diminished as expected, but instead of improving women’s scores, they dropped just as much as men.

Pavlova and her colleagues also looked at positive messages. Telling participants that women are usually better at the EA test modestly improved women’s scores without affecting men. However, the opposite was not true. Women’s performance was even more hurt by being told that men are better at the test than the more explicit message that women are worse.

What clearly emerges from the study is that women are more susceptible to stereotyping than men. The only time men’s performance declined was when given the explicit negative male message.

Why are women more impacted by the stereotypes than men? Although controlling for preexisting stereotypes on this specific test, researchers cannot escape society’s influence on women, which begins at an incredibly early age. Women are constantly under the threat of stereotype. And women who break stereotypes face harsh criticism not faced by men, such as criticism of working mothers who use daycare or the perception of women who speak up as being aggressive or bossy rather than being leaders.

The researchers suggest that since women have a history of being typecast, they may misinterpret the message “males are usually worse” to mean that if men have a hard time with the test, women will have an even harder time.

More and more studies confirm the existence of subtle forms of bias against women at all levels of society. It is a major finding that these subtle biases can have even greater psychological consequences than more blatant and bygone forms of sexism. Interventions are needed to combat existing stereotypes at an early age.

In my latest post for 3Quarksdaily, I use the Autocomplete function built into Google searches to check out search query phrases which are popular among web users. I was inspired to write this post after I came across an anti-misogyny campaign promoted by UN Women and a recent article in Slate which unveiled the Autocomplete prompt “scientists are liars”. The UN Women campaign and the Slate article are linked in my 3QD post and are both worth checking out. I hope you enjoy the articles and have fun creating your own Google Autocomplete prose poems.